Comprehensive review of fluorescence applications in gynecology

Since the introduction of indocyanine green (ICG) as a fluorophore in near-infrared imaging, fluorescence visualization has become an essential tool in many fields of surgery. In the field of gynecology, recent new applications have been proposed and found their place in clinical practice. Different applications in gynecology were investigated, subcategorized, and overviewed concerning surgical applications and available dyes. Specific applications in which fluorescence-guided surgery was implemented in gynecology are described in this manuscript—namely, sentinel node biopsy, mesometrium visualization, angiography of different organs, safety issues in pregnant women, ureters visualization, detection of peritoneal metastases, targeted fluorophores for cancer detection, fluorescent contamination hysterectomy, lymphography for lower limb lymphedema prevention, tumor margin detection, endometriosis, and metastases mapping. With evolving technology, further innovative research on the new applications of fluorescence visualization in cancer surgery may help to establish these techniques as standards of high-quality surgery in gynecology. However, more investigations are necessary in order to assess if these innovative tools can also be effective to improve patient outcomes and quality of life in different gynecologic malignancies

Tweeting the meeting: Quantitative and qualitative twitter activity during the 38th ESSO conference.

Abstract Introduction Social media is increasingly used to share information with the potential for fast and wide reach. Data on use during surgical oncology conferences is limited. We aimed to monitor twitter usage during a surgical oncology conference to audit impact of activity. Methods A prospective, time-restricted, observational study of twitter activity using the #ESSO38 hashtag in the week before and during the 38th ESSO conference (10–12 October 2018; Budapest, Hungary). Data on individual tweets and retweets, including date and tweeter or retweeter were collected using NodeXL, FollowTheHashtag, Twitonomy and TAGS. Results The study period (10–13 October) documented 328 tweets by 58 tweeters with 1167 retweets, with a soaring activity and mentions during the conference days, with a potential reach at over 7.5 million. The nodal network of tweets, the most active tweeters and retweeters are presented as well as the most frequently used hashtags. The top 3 hashtags used were #ESSO38, #SoMe4Surgery# and #EYSAC. A positive influence on the @ESSOweb twitter handle was noted, with the numbers of followers growing from 1.5 K to over 1.8 K representing a 20% growth in just over a week. Conclusions Activity on tweeter during the conference was considerable, with a potential for a wide reach beyond those attending the conference. A more structured approach to the use of twitter for future conferences may enhance experience, activity and reach

Shallow shear-wave reflection seismics in the tsunami struck Krueng Aceh River Basin, Sumatra

International audienceAs part of the project "Management of Georisk" (MANGEONAD) of the Federal Institute for Geosciences and Natural Resources (BGR), Hanover, high resolution shallow shear-wave reflection seismics was applied in the Indonesian province Nanggroe Aceh Darussalam, North Sumatra in cooperation with the Government of Indonesia, local counterparts, and the Leibniz Institute for Applied Geosciences, Hanover. The investigations were expected to support classification of earthquake site effects for the reconstruction of buildings and infrastructure as well as for groundwater exploration. The study focussed on the city of Banda Aceh and the surroundings of Aceh Besar. The shear-wave seismic surveys were done parallel to standard geoengineering investigations like cone penetrometer tests to support subsequent site specific statistical calibration. They were also partly supplemented by shallow p-wave seismics for the identification of (a) elastic subsurface parameters and (b) zones with abundance of groundwater. Evaluation of seismic site effects based on shallow reflection seismics has in fact been found to be a highly useful method in Aceh province. In particular, use of a vibratory seismic source was essential for successful application of shear-wave seismics in the city of Banda Aceh and in areas with compacted ground like on farm tracks in the surroundings, presenting mostly agricultural land use areas. We thus were able to explore the mechanical stiffness of the subsurface down to 100 m depth, occasionally even deeper, with remarkably high resolution. The results were transferred into geotechnical site classification in terms of the International Building Code (IBC, 2003). The seismic images give also insights into the history of the basin sedimentation processes of the Krueng Aceh River delta, which is relevant for the exploration of new areas for construction of safe foundations of buildings and for identification of fresh water aquifers in the tsunami flooded region

Shallow shear-wave reflection seismics in the tsunami struck Krueng Aceh River Basin, Sumatra

As part of the project "Management of Georisk" (MANGEONAD) of the Federal Institute for Geosciences and Natural Resources (BGR), Hanover, high resolution shallow shear-wave reflection seismics was applied in the Indonesian province Nanggroe Aceh Darussalam, North Sumatra in cooperation with the Government of Indonesia, local counterparts, and the Leibniz Institute for Applied Geosciences, Hanover. The investigations were expected to support classification of earthquake site effects for the reconstruction of buildings and infrastructure as well as for groundwater exploration. The study focus sed on the city of Banda Aceh and the surroundings of Aceh Besar. The shear-wave seismic surveys were done parallel to standard geoengineering investigations like cone penetrometer tests to support subsequent site specific statistical calibration. They were also partly supplemented by shallow p-wave seismics for the identification of (a) elastic subsurface parameters and (b) zones with abundance of groundwater. Evaluation of seismic site effects based on shallow reflection seismics has in fact been found to be a highly useful method in Aceh province. In particular, use of a vibratory seismic source was essential for successful application of shear-wave seismics in the city of Banda Aceh and in areas with compacted ground like on farm tracks in the surroundings, presenting mostly agricultural land use areas. We thus were able to explore the mechanical stiffness of the subsurface down to 100 m depth, occasionally even deeper, with remarkably high resolution. The results were transferred into geotechnical site classification in terms of the International Building Code (IBC, 2003). The seismic images give also insights into the history of the basin sedimentation processes of the Krueng Aceh River delta, which is relevant for the exploration of new areas for construction of safe foundations of buildings and for identification of fresh water aquifers in the tsunami flooded region

S-wave velocity measurements applied to the seismic microzonation of Basel, Upper Rhine Graben

An extensive S-wave velocity survey had been carried out in the frame of a recent seismic microzonation study of Basel and the border areas between Switzerland, France and Germany. The aim was to better constrain the seismic amplification potential of the surface layers. The survey included single station (H/V spectral ratios) and ambient vibration array measurements carried out by the Swiss team, as well as active S-wave velocity measurements performed by the German and French partners. This paper is focused on the application of the array technique, which consists in recording ambient vibrations with a number of seismological stations. Several practical aspects related to the field measurements are outlined. The signal processing aims to determine the dispersion curves of surface waves contained in the ambient vibrations. The inversion of the dispersion curve provides a 1-D S-wave velocity model for the investigated site down to a depth related to the size of the array. Since the size of arrays is theoretically not limited, arrays are known to be well adapted for investigations in deep sediment basins, such as the Upper Rhine Graben including the area of the city of Basel. In this region, 27 array measurements with varying station configurations have been carried out to determine the S-wave velocity properties of the geological layers down to a depth of 100-250 m. For eight sites, the outputs of the array measurements have been compared with the results of the other investigations using active sources, the spectral analysis of surface waves (SASW) and S-wave reflection seismics. Borehole information available for a few sites could be used to calibrate the geophysical measurements. By this comparison, the advantages and disadvantages of the array method and the other techniques are outlined with regard to the effectiveness of the methods and the required investigation depth. The dispersion curves measured with the arrays and the SASW technique were also combined and inverted simultaneously to use the advantages of both methods. Finally, the paper outlines and discusses the contribution of the S-wave velocity survey to the new seismic microzonation of the Basel region. In this regard one major outcome of the survey is the quantification of vertical and lateral changes of the S-wave velocity, due to changing lithology or changing compaction and degree of weathering of the layer

Underestimation of cancer in case of diagnosis of atypical ductal hyperplasia (ADH) by vacuum assisted core needle biopsy

AbstractBackgroundWith the introduction of mammography screening, we are more often dealing with the diagnosis of precancerous and preinvasive breast lesions. An increasing number of patients are observed to show a premalignant change of ADH (atypical ductal hyperplasia). It also involves a wider use of the vacuum assisted core biopsy as a tool for verifying nonpalpable changes identified by mammography.AimThis paper describes our experience of 134 cases of ADH diagnosed at Mammotome® vacuum core needle biopsy.Material and methodsOf 4326 mammotomic biopsies performed at our institution in 2000–2006, ADH was diagnosed in 134 patients (3.1%). Patients underwent surgery to remove the suspected lesion. All histopathological blocks were again reviewed by one pathologist. Clinical, radiological and pathological data were collected for statistical evaluation.ResultsUnderestimation of invasive changes occurred in 12 patients (9%). The only clinicopathologic feature of statistical significance radiologically and pathologically was the presence of radial scar in the mammography.ConclusionsMore frequent diagnosis of precancerous changes in the mammotomic breast biopsy forces us to establish a clear clinical practice. The problem is the underestimation of invasive changes. The occurrence of radial scar on mammography for diagnosis of the presence of ADH increases the risk of invasive changes

Structural analysis of S-wave seismics around an urban sinkhole: evidence of enhanced dissolution in a strike-slip fault zone

In November 2010, a large sinkhole opened up in the urban area of Schmalkalden, Germany. To determine the key factors which benefited the development of this collapse structure and therefore the dissolution, we carried out several shear-wave reflection-seismic profiles around the sinkhole. In the seismic sections we see evidence of the Mesozoic tectonic movement in the form of a NW–SE striking, dextral strike-slip fault, known as the Heßleser Fault, which faulted and fractured the subsurface below the town. The strike-slip faulting created a zone of small blocks ( < 100 m in size), around which steep-dipping normal faults, reverse faults and a dense fracture network serve as fluid pathways for the artesian-confined groundwater. The faults also acted as barriers for horizontal groundwater flow perpendicular to the fault planes. Instead groundwater flows along the faults which serve as conduits and forms cavities in the Permian deposits below ca. 60 m depth. Mass movements and the resulting cavities lead to the formation of sinkholes and dissolution-induced depressions. Since the processes are still ongoing, the occurrence of a new sinkhole cannot be ruled out. This case study demonstrates how S-wave seismics can characterize a sinkhole and, together with geological information, can be used to study the processes that result in sinkhole formation, such as a near-surface fault zone located in soluble rocks. The more complex the fault geometry and interaction between faults, the more prone an area is to sinkhole occurrence

Tweeting the meeting. Quantitative and qualitative twitter activity during the 38th ESSO conference

Introduction: Social media is increasingly used to share information with the potential for fast and wide reach. Data on use during surgical oncology conferences is limited. We aimed to monitor twitter usage during a surgical oncology conference to audit impact of activity. Methods: A prospective, time-restricted, observational study of twitter activity using the #ESSO38 hashtag in the week before and during the 38th ESSO conference (10–12 October 2018; Budapest, Hungary). Data on individual tweets and retweets, including date and tweeter or retweeter were collected using NodeXL, FollowTheHashtag, Twitonomy and TAGS. Results: The study period (10–13 October) documented 328 tweets by 58 tweeters with 1167 retweets, with a soaring activity and mentions during the conference days, with a potential reach at over 7.5 million. The nodal network of tweets, the most active tweeters and retweeters are presented as well as the most frequently used hashtags. The top 3 hashtags used were #ESSO38, #SoMe4Surgery# and #EYSAC. A positive influence on the @ESSOweb twitter handle was noted, with the numbers of followers growing from 1.5 K to over 1.8 K representing a 20% growth in just over a week. Conclusions: Activity on tweeter during the conference was considerable, with a potential for a wide reach beyond those attending the conference. A more structured approach to the use of twitter for future conferences may enhance experience, activity and reach

Ambient noise analysis for characterizing sub-surface dynamic parameters

Ambient noise analysis of horizontal to vertical spectral ratio (HVSR) method has been used widely to provide reliable estimates of the site fundamental frequency and to constrain the inversion of near-surface shear wave velocity. The present paper focuses on the site measurement using the aforementioned analysis by means of the HVSR method for characterizing sub-surface dynamic parameters in the City of Banda Aceh, Indonesia. A Guralp CMG-6TD broadband seismometer was used in this study to cover a wide frequency range from 0.033 Hz to 50 Hz in standard operation. The instrument was deployed at two different sites (i.e. Location#1 of Blang Padang and Location#2 of Stadion Dirmutala) in the City of Banda Aceh for at least 2 hours for ambient noise recording. This continuous of 2 hours' microtremor time series was separated into 30 minutes record from which the site fundamental frequency and shear wave velocity of the measured site were deduced. The later sub-surface dynamic parameter was validated using another technique of reflection seismic. This investigation suggests the fundamental frequency of 0.45 Hz at Location#1 and of 0.65 Hz at Location#2. The estimated shear wave velocity of the top 30 m, Vs,30 of this investigation is 165 m/s at Location#1 and 156 m/s at Location#2. Both the site fundamental frequency and shear wave velocity are important for infrastructure design in the high seismic region of Banda Aceh, Indonesia

Multimodal treatment of gastric cancer in the west: Where are we going?

The incidence of gastric cancer (GC) is decreasing worldwide, especially for intestinal histotype of the distal third of the stomach. On the contrary, proximal location and diffuse Lauren histotype have been reported to be generally stable over time. In the west, no clear improvement in long-term results was observed in clinical and population-based studies. Results of treatment in these neoplasms are strictly dependent on tumor stage. Adequate surgery and extended lymphadenectomy are associated with good long-term outcome in early-stage cancer; however, results are still unsatisfactory for advanced stages (III and IV), for which additional treatments could provide a survival benefit. This implies a tailored approach to GC. The aim of this review was to summarize the main multimodal treatment options in advanced resectable GC. Perioperative or postoperative treatments, including chemotherapy, chemoradiotherapy, targeted therapies, and hyperthermic intraperitoneal chemotherapy have been reviewed, and the main ongoing and completed trials have been analyzed. An original tailored multimodal approach to non-cardia GC has been also proposed